This application and the requested attachments must be received by 4:00 PM, November 5, 2003 ATTN: Miriam Piñeiro-Cortés, Director, Fundraising Training, The Center for Responsible Funding, 924 Cherry Street, Suite 520, Philadelphia, PA 19107.

Organization

Address

Telephone

Fax

E-mail

Executive Director

Contact Person (if different from above)

Board President/Chair

Please answer the following questions:

1. What is the mission of your organization? In what way does your mission/work further social change? Please elaborate.

2. Do you have a "complete" case statement, i.e., mission and vision statements, goals, objectives, strategies, organizational history?

3.How does your organization go about achieving your mission?

4.Who do you define as your community? What communities or groups benefit from the activities and/or advocacy of your organization?

5.What is your operating budget for this current fiscal year? How much money do you currently raise from individuals each year? List your current funding sources.

6. Who helps in raising funds for your organization? During the past year, who from your organization have helped to raise funds? Please prepare a list indicating who they are and in which capacity they worked.

7. Has your organization participated in any type of fundraising training in the past, i.e., Kim Klein seminars, La Salle's Nonprofit Center, etc.? Who from your organization participated in the training?

8. What is your current fundraising plan for the year? Have you faced any obstacles?

9. Why do you want to participate in the SAGE program?

10. Who (board, staff, volunteers, community person, administrator) will represent your organization in this program? Enclose commitment letters from the participants who will attend the seminar and participate in the yearlong program.

Please Attach:
List of Board of Directors and their affiliations
IRS 501(c) (3) Tax exempt letter
PA Charitable Solicitation Certificate
Letter from Fiscal Sponsor, if applicable